Individual provider Active NPI

Amanda Dale-Shall

  • Pediatric Allergy/Immunology Physician
  • Charlotte, NC
National Provider Identifier
1033222864
Registry record updated Feb 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Allergy/Immunology PhysicianTaxonomy code 2080P0201X
License
2007-00714 Issued in NC
Practice address
1001 Blythe Blvd
Medical Center Plaza Suite 200
Charlotte, NC 28203-5866
Phone
(704) 381-8840
NPI assigned
Aug 16, 2006
Last updated
Feb 12, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Allergy/Immunology Physician 2080P0201X 2007-00714 NC Primary

Addresses

Primary practice location

1001 Blythe Blvd
Medical Center Plaza Suite 200
Charlotte, NC 28203-5866

Mailing address

1001 Blythe Blvd
Charlotte, NC 28203-5866

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071005000509 NC Practitioner - Pediatric Medicine 6608961610 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Toledo Medical College, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolinas Medical CenterGroup PAC ID 4789597477, 1,057 clinicians

Practice addresses (Care Compare)

1000 Blythe Blvd
Charlotte, NC 28203-5812
Phone (704) 355-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2007-00714NCMDPediatric Allergy/Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Medical Center Current Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Dec 8, 2025 Accepting new patients
Carolinas Medical Center CurrentSince Aug 6, 2007 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Dec 8, 2025 Accepting new patients
Carolinas Medical Center CurrentSince Aug 6, 2007 Accepting new patients
Carolinas Medical Center Past Accepting new patients

Locations

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

1001 Blythe Blvd
Ste 200
Charlotte, NC 28203
Phone (704) 373-0544

Interoperability endpoints

  • Direct secure messaging: adaleshall136513@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549929600000",
    "number": "1033222864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 BLYTHE BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 BLYTHE BLVD",
            "address_2": "MEDICAL CENTER PLAZA SUITE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035866",
            "telephone_number": "704-381-8840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALE-SHALL",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-16",
        "last_updated": "2019-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0201X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Allergy/Immunology",
            "state": "NC",
            "license": "2007-00714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.